Culture yield of 1st and 2nd biopsy in bacterial non-mycobacterial spondylodiscitis in a university hospital - 29/04/25
, F Grados a, J Meynier b, D Michel c, JP Lanoix d, P. Fardellone a, V Goëb aHighlights |
• | The second percutaneous image-guided spine biopsies are less efficient than the first. |
• | More than half of patients receive antibiotics before percutaneous image-guided spine biopsies. |
• | CRP, age, needle size and histopathology are associated with the culture yield. |
• | The usefulness of systematic-post percutaneous image-guided spine biopsies blood culture seems to be limited. |
Abstract |
Introduction |
In cases of infectious spondylodiscitis (ISD) where blood cultures are negative, disco-vertebral puncture-biopsy (DVPB) is recommended. In the event of a sterile result, existing literature does not definitively answer the question of whether to initiate empirical antibiotic therapy or to conduct a second DVPB. The aim of this study was to assess the culture yield of DVPB in ISD and to identify the factors associated with a positive DVPB.
Materials and methods |
A retrospective single-center study was conducted, encompassing all adult patients with ISD having undergone DVPB between 01/01/2009 and 31/10/2021.
Results |
A total of 177 patients were included. The yield of the first DVPB was 48.6 %. The second DVPB yielded 8.7 % (p < 0.001). Factors significantly associated with the yield of the first DVPB included younger age (p = 0.003), higher CRP levels (p = 0.0496), larger needle size (p = 0.023), and histopathology supporting ISD (p = 0.001), while prior antibiotic therapy (p = 0.001) is a factor associated with negative culture. The second DVPB increased the culture yield by 19.3 %.
Conclusion |
The yield of the second biopsy is lower than that of the first biopsy but provides an additional diagnostic gain of 19.3%. Antibiotic therapy prior to DVB significantly decreases their yield. The utility of routine post-DVPB blood cultures appears to be limited.
Le texte complet de cet article est disponible en PDF.Keywords : Spondylodiscitis, Biopsy, Culture yield, Antibiotics, Discitis
Plan
Vol 55 - N° 3
Article 105041- mai 2025 Retour au numéro
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